Purpose: We aimed to determine the rates and independent predictors of free flap compromise requiring reoperation after autologous breast reconstruction.Methods:Retrospective review of the relevant ACS-NSQIP 2012-2014 prospectively collected data. We performed multivariable logistic regression analysis to determine independent predictors of unplanned reoperation.Results: Inpatient status, obesity (BMI ≥30.0), hypertension, American Society of Anesthesiology (ASA) class ≥3, and smoking were independent predictors of unplanned reoperation (all p<0.05, Table 1). Of the 3,666 patient cohort, 4.7% required reoperation between the end of surgery and end of POD1, 1.1% required reoperation during POD2 (Figure 1). Risk factors did not significantly increase the likelihood of reoperation on POD2: a comparable proportion of patients with risk factors (0.6%) underwent reoperation as compared to those without risk factors (0.5%). Daily reoperation rates were consistently low after POD2 (Figure 2).Conclusion: Given the low rate of breast free flap compromise following POD2, providers may consider discontinuing monitoring after the first 48 hours. By exerting more judicious post-operative management for these patients, providers can generate tremendous savings for the health care system.